Type 1 diabetes (T1D) is a widely spread disease both among the adult population and children. Since this type of diabetes demands regular insulin injections, it can negatively influence the quality of life, which is particularly undesirable for young patients. Moreover, children are less responsible and careless about their health, which can have negative consequences in case a patient does not get a dose of insulin on time.
Finally, the education and social life of children can suffer because they miss classes or other social events due to their disease (Holmström et al., 2017). In recent decades, a new method of managing T1D appeared, insulin pump therapy (IPT). At present, it is a standard treatment for T1D, which provides patients with more freedom in their daily activities (Lang et al., 2016). This project is dedicated to the analysis of findings of the study by Johnson, Cooper, Jones, and Davis (2013), which investigates the long-term outcome of insulin pump therapy in children with T1D.
Research Findings Summary
Technological improvements of insulin pumps during recent decades made insulin pump therapy a popular intervention for T1D patients on the whole and children in particular. The study by Johnson et al. (2013) aims to determine the influence of insulin pump therapy on long-term glycemic control, body mass index (BMI), rate of severe hypoglycemia, as well as diabetic ketoacidosis (DKA) in children.
The case-control design of research allowed matching patients who selected insulin pump therapy and those who preferred injection therapy. The researchers present some findings that allow evaluating insulin pump therapy as a method to improve glycemic control and other vital parameters as well as to preserve the quality of life of T1D patients. The study involved 345 participants, the patients of PMH Diabetes Clinics, who met the research criteria. The average age of participants at the time of pump therapy start was 11.5 years.
The major finding of the current research is related to glycemic control. Thus, the study revealed the fact that although the rate of glycated hemoglobin (HbA1c) was similar for both groups before the experiment, the group on insulin pump therapy demonstrated a significant improvement in HbA1c (Johnson et al., 2013). Another indicator under investigation was the rate of severe hypoglycemia. Thus, before insulin pump therapy, the rate of severe hypoglycemia was higher among the participants of the pump group. After the therapy started, the rate of severe hypoglycemia decreased to half compared to that recorded before pump therapy.
As for complications such as diabetic ketoacidosis, their rates were equal for both groups before pump therapy initiation. After insulin pump therapy, the situation changed and there were twice fewer hospitalizations because of diabetic ketoacidosis among patients using pump therapy compared to those using injections. Finally, the BMI of participants included in the two groups was also similar before the experiment. After insulin pump therapy, the insulin dose decreased among patients applying it by 9% while non-pump patients observed an 11% increase in insulin requirement (Johnson et al., 2013).
On the whole, the study findings lead the researchers to a conclusion that insulin pump therapy results in a substantial improvement in sustainable glycemic control. The researchers were observing the patient during the period of up to seven years, and at the majority of measurements, insulin pump therapy demonstrated a positive impact on the meaningful indicators for T1D patients such as HbA1c, diabetic ketoacidosis, rate of severe hypoglycemia, and BMI.
The majority of findings correlate with earlier investigations. Thus, the mean improvement in HbA1c revealed in this research supports other studies that showed similar results (Johnson et al., 2013). Moreover, it should be mentioned that this change is clinically significant. Another benefit of insulin pump therapy that was revealed is the reduction in severe hypoglycemia rate. Thus, the group using pump therapy demonstrated a 30% lower rate of severe hypoglycemia compared to the injection group. Later researches dedicated to the issue of insulin pump therapy reveal the improvement in long-term glycemic control. Thus, Lang et al. (2016), evaluating the same indicators (HbA1c, rate of severe hypoglycemia, and diabetic ketoacidosis, prove that initiation of insulin pump therapy in children positively influences HbA1c rate.
Conclusion
To summarizing, it should be mentioned that insulin pump therapy is one of the contemporary tools that help to manage diabetes. It empowers blood glucose control and provides an individual with regular necessary doses of insulin thus helping to avoid complications such as diabetic ketoacidosis, severe hypoglycemia, or BMI increase. Insulin pump therapy is particularly beneficial for children with type 1 diabetes who frequently lack self-control and are more likely to develop complications than conscious adult patients.
The study under analysis proves the efficiency of insulin pump therapy for children. a large case-control study provides evidence of long-term positive outcomes for type 1 diabetes patients utilizing insulin pumps compared to those using insulin injections. Apart from evident health benefits, insulin pump therapy helps to preserve the quality of life and allows living a normal life, which is frequently a problem for insulin-dependent patients.
References
Holmström, M., Häggström, M., Audulv, Å., Junehag, L., Coyne, I., & Söderberg, S. (2017). To integrate and manage diabetes in school: Youth’s experiences of living with Type 1 diabetes in relation to school – a qualitative study. International Diabetes Nursing, 1-6. Web.
Johnson, S., Cooper, M., Jones, T., & Davis, E. (2013). Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study. Diabetologia, 56(11), 2392-2400. Web.
Lang, E., King, B., Miller, M., Dunn, S., Price, D., & Foskett, D. (2016). Initiation of insulin pump therapy in children at diagnosis of type 1 diabetes resulted in improved long-term glycemic control. Pediatric Diabetes, 18(1), 26-32. Web.